The efficacy of acamprosate and naltrexone in the treatment of alcohol dependence, Europe versus the rest of the world: a meta-analysis.

摘要: Aims To determine the efficacy of acamprosate and naltrexone in treatment those who are alcohol-dependent reducing lapse/relapse to alcohol consumption discontinuation, examine whether a proportion variance study outcome can be explained by country which trials have taken place. Method A systematic review meta-analysis randomized controlled published before September 2013 was conducted. The primary measures were or compared placebo dependence discontinuation. Twenty-two (RCTs) met inclusion criteria for meta-analysis, with total 2649 participants group 2587 group. Twenty-seven RCTs 2253 1946 A random-effects model using Mantel–Haenszel method applied conduct meta-analysis. Variance outcomes explored subgroup analysis Europe versus rest world (ROW). Results The risk returning any drinking at 6 months significantly lower [risk ratio (RR) = 0.83, 95% confidence interval (CI) = 0.78–0.89]. There little difference discontinuing reason (RR = 0.91, CI = 0.83–1.00) due adverse events (RR = 1.30, CI = 0.96–1.75) groups. individuals approximately 3 reduced (RR = 0.92, CI = 0.86–1.00), as relapsing heavy (RR = 0.85, CI = 0.78–0.93). no significant between (RR = 0.94, CI = 0.84–1.05). greater (RR = 1.72, CI = 1.10–2.70). Subgroup (Europe ROW) revealed events. For discontinuation reason, there RR ROW (χ2 = 11.65, P <0.001) acamprosate. Acamprosate associated reduction (RR = 0.86, CI = 0.79–0.95), but an increase (RR = 1.23, CI = 1.03–1.48). Conclusions Both appear reduce alcohol-dependent. control trial (RCT) is completed does not explain effects. However, RCT may important explaining studies ‘discontinuing reason’.